THIRD CAESAREAN SECTION IN PATIENT WITH MYASTENIA GRAVIS

MYASTENIA GRAVIS (MG) IS AN AUTOIMMUNE NEUROMUSCULAR DISEASE, CHARACTERISED BY MUSCLE WEAKNESS AND FATIGABILITY OF THE VOLUNTARY MUSCLES, IT AFFECTS YOUNG WOMEN IN THE SECOND AND THIRD DECADE OF LIFE. WE REPORT A CASE OF 30 YEARS OLD MULTIGRAVIDA WOMEN WITH MYASTENIA GRAVIS SUBMITTED TO THIRD ITERATIVE CASEAREAN SECTION WITH NO ADVERSE NEONATAL AND MATERNAL OUTCOME. THE COURSE OF MYASTENIA IS HIGHLY VARIABLE AND UNPREDICTABLE DURING GESTATION AND CAN CHANGE IN SUBSEQUENT PREGNANCIES. DELIVERY SPECIALLY, THROUGH CAESAREAN SECTION IS VERY STRESSFUL AND MAY CAUSE SEVERE MYASTHENIC CRISIS. ALTHOUGH PREGNANCY AND DELIVERY RAPRESENT PARTICULAR EVENTS, THAT REQUIRE MORE ATTENTION IN THESE PATIENTS, THEY ARE NOT ASSOCIATED, IN MOST CAUSES, WITH HIGHER RISK OF COMPLICATIONS COMPARATED TO NORMAL PREGNANCY,DELIVERY AND POSTPARTUM PERIOD.ACCORDING OUR EXPERIENCES, IN THE MANAGMENT OF MYASTHENIC PREGNANT WOMAN IS NECESSARY COOPERATION IN A MULTIDISCIPLINARY TEAM BETWEEN OBSTETRICIANS,NEUROLOGIST, ANAESTHESIST, ANCD NEONATOLOGIST FOR ENSURE AN OPTIMUM OUTCOME.